STEPHANIE D JACKSON (APRN) – Family Nurse Practitioner, NPI 1073258380
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
11,637 NURSE PRACTITIONER in IL
Provider Addresses for STEPHANIE D JACKSON (APRN)
1901 S 4th St Ste 26
Effingham, IL 624014188
Phone: (217) 660-4600
Fax: (217) 334-0027
Type: Location
901 N MAPLE ST
EFFINGHAM, IL 624016401
Phone: (217) 347-2900
Type: Mailing
900 W TEMPLE AVE
EFFINGHAM, IL 624012121
Phone: (217) 347-0458
Type: Mailing
900 W TEMPLE AVE STE 1500
EFFINGHAM, IL 624012121
Phone: (217) 347-0458
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 36 Open Payments records for all available years, with a total value of $755.
Total Amount is formed as General ($755) + Research ($0) + Ownership ($0) = $755.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: ABBVIE INC. ($249).
Total Amount
$755
General + Research + Ownership
Payments
36
Total payment records
General Amount
$755
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $249 |
| Novo Nordisk Inc | $167 |
| Esperion Therapeutics, Inc. | $85 |
| Lilly USA, LLC | $74 |
| Novartis Pharmaceuticals Corporation | $71 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-03-24
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230324001978 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 55 | 25 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 53 | 26 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 36 | 20 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 23 | 22 | $0 |
Insurance plans in this area (ZIP 62401)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | IL | |
| - | IL | |
| Family Practice | IL | |
| - | IL | |
| General Surgery | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Gastroenterology, Internal Medicine | IL | |
| - | IL |
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